单向倒刺可吸收缝线在胆总管探查一期缝合中的应用

Application of Knotless Choledochorraphy by Unidirectional Barbed Continuous Suture after Laparoscopic Common Bile Duct Exploration

目的探讨单向倒刺可吸收缝线连续缝合在腹腔镜微创胆总管探查一期缝合中的效果及安全性。方法回顾性分析宝鸡市中医医院2014年1月~2017年11月收治的行胆总管探查一期缝合患者共138例临床资料,根据缝合方案不同分为A组(69例)和B组(69例),分别采用普通和单向倒刺可吸收缝线行连续缝合;比较两组手术相关临床指标和术后并发症发生率。结果两组手术时间、术中出血量及术后总住院时间比较差异无统计学意义(P>0.05);B组术中胆总管缝合时间显著少于A组(P<0.05);两组术后急性胆管炎和胆漏发生率比较,差异无统计学意义(P>0.05)。结论单向倒刺可吸收缝线连续缝合用于行微创胆总管探查一期缝合患者能够有效缩短缝合用时,降低操作难度,且未导致术后并发症发生风险增加,价值优于普通可吸收缝线。

To investigate the effect and safety of uidirectional barbed absorbable continuous suture after laparoscopic common bile duct exploration.Methods It was studied retrospectively in 138 patients underwent laparoscpic common bile duct exploration in the period from January 2014 to November 2017 in Hospital of Traditional Chinese Medicine of Baoji.There were 69 patients of group A treated with traditional continuous suture,and 69 patients of group B with uidirectional barbed absorbable continuous suture after laparoscopic common bile duct exploration.And the operation-related clinical indexes and postoperative complication incidence of both groups were compared.Results There was no significant difference in operation time,intraoperative blood loss and postoperative hospital stay between the two groups(P>0.05).The intraoperative choledochal suture time of group B were significantly less than group A(P<0.05).There was no significant difference in the incidence of acute cholangitis and bile leakage between two groups(P>0.05).Conclusion Compared with common absorbable suture,uidirectional barbed absorbable continuous suture can efficiently shorten suture time,reduce operation difficulty,with no increasing risk of postoperative complications in the treatment of laparoscopic common bile duct exploration.